Happy Halloween! In the spirit of the holiday I’ve decided to share my gruesome tale of nearly getting my foot amputated (being facetious for effect) because I was stupid enough to get into a fight with fire coral which ripped my foot open and then frolic barefoot in the mud and sand on a rural Philippine’s farm. Every day is a learning day and today I would like to share about the dangers of cellulitis combined with stupidity.
What is Cellulitis:
Cellulitis is an infection of the deeper layers of skin and the underlying tissue. It can be serious if not treated promptly. The infection develops suddenly and can spread through the body quickly. Severe infections can spread deep into the body, and can be life threatening. –NHS
According to a recent study, 1 out of every 40 people will experience cellulitis at some point, with elderly individuals and backpackers being at a higher risk.
To avoid it, make sure to keep open wounds clean and dry, preventative care is much more effective since there are antibiotics resistant strains out there now that can make this infection life threatening even in the best of circumstances.
In this post I will show you the progression of my wreck diving wound to full blown cellulitis and how the antibiotics defeated the infection. If you’re squeamish at all or hate gross feet pics then please turn back now. You have been warned.
The Quarrel with Coral Begins on a Tropical Sunny Day in Paradise:
Warm sun in the sky, beautiful boats nearby, crystal clear waters, and a Japanese WWII sunken ship just 20 or so feet below us. I’ve had some experience free diving in some of Florida’s hot springs and was up for the challenge to swim through the dilapitaded hull of this small ship. It was an explosion of color as marine life was colonizing it, and the hull looked deep enough to swim through easy, never mind that my breath holding skills were out of practice by a few years.
Down I gleefully went with my GoPro to get some great footage to make my friends jealous back home as I effortlessly glided into it’s arching walls and at that moment my lack of breath hit me while I was wide-eyed admiring the corrugated metals mixed with coral.
NOTE TO NEWBIE FREEDIVERS: I was later told this and wanted to share my first nugget of wisdom (also pls comment to correct me if I’m wrong, I’m merely repeating what I heard and I’d like to know what other true divers think) – apparently, if you’re in a wreck, you’re never supposed to kick willy-nilly in tight spaces. No, you’re supposed to use your hands (with gloves) to guide you along. In case, you know, you hit something with your foot.
Anyways, I kicked the shit out of this coral, right in its face, and in return it sliced my foot open in a few places. I barely felt it as I dolphin kicked my way up to the glimmering surface and to sweet fresh air. It was the crimson blood mixing in with the shimmering blues that cued me in to the injury and so I swam my way to the boat to take a good look at what I had done to myself.
Initial Wound Care
Thankfully on the boat, one of the other passengers worked for many years as an EMT on the California beaches and he immediately set to work on cleaning my foot despite my best efforts to be the worst possible patient (thanks Riley!). He told me that coral cuts are a serious deal because the bacterial and living organisms found in coral can grow inside the human body and colonize your wound, leading to courses of antibiotics and potential bone scraping to get the foreign invaders out.
Meh, like I’ve let injuries slow me down. Besides, everyone talks about infection but it never actually happens right? Right?
The Horror Slide Show
Follow this horror show below of my terrible looking feet and their terrible new injury that lead to an unwanted bacterial visitor. I have no one to blame but myself, rum, good music, and my excitement at seeing pigs running amok in a village and the need to go after them – barefoot. It begins with a potential bone break, crescendos at my foot swollen and bursting at the seems, and then recovery with powerful antibiotics and the end of my foot modeling career.
Day One (October 2nd, 2022)
This is the evening of the day I decided to pick a quarrel with the coral. Picture taken right before the second cleaning and wound management. As you can see it doesn’t look too bad, I didn’t think too much of it. How I thought about everything: 9/10
Day Two (October 3rd)
Again, not looking so bad, wounds don’t look infected at all and while walking hurts a bit I still have functionality. I was thinking it was just like a bruise and would fade in a few days, wouldn’t hold me back from much. Rating: 9/10
Day Three (October 4th)
It’s a bit swollen and infection site is a bit white on the deeper cut thought I think that was more due to the antibiotic cream I was using at the time. The swelling isn’t completely unexpected, especially because at the time I was still diving, playing volleyball, and overall active. I had hit the top of my foot really hard against that coral and there was a smaaallll possibility I had broken a small bone on the top of my foot. Rating: 8/10
Day Five (October 6th)
The previous day it had felt and looked good so I went a bit wild. The night before I drank rum and danced on the beach until I jumped into the moonlight reflected surf and watched stingrays go by while laughing with the other expedition goers. The following day we explored the farm on the island we were on and I delighted in seeing the little piglets roaming around and had to go after them. Barefoot. In the mud. Where all the farm animals freely pooped. You can’t fix stupid. I suffered for those multiple mistakes and you can start to see the beginnings of an infection as the redness and swelling set in.
At this point, it’s also painful to walk and so not only am I dumb, but I’m also hobbling everywhere and my shoe won’t slide on because my foot is too swollen. Rating: 6/10, at this point I’m feeling pretty sorry for myself but I was completely unaware of the pain coming my way.
Day Six (October 7th)
I flew from El Nido to Manila to get the foot checked out since there were two doctors on the expedition that gave me polite grimaces when they saw my foot, telling me that it was getting worse than just a wait and see situation. This photo is from St Lukes Medical where they took great care of me, the concierge even got me bellhops to carry my bags and a wheelchair because at this point I was limping badly from the pain of putting weight on my foot.
The orange is the antiseptic cream they put on the wounds. The doctor gave me Celecoxib for pain relief (like Tylenol but different chemical mechanisms) and Ciprofloxacin as a generic antibiotic to fight what he believed was the onset of a coral infection. When I did some research there are some people against Ciprofloxacin because it’s been prescribed so often that there are now many strains of bacteria that are resistant to it. Rating 4/10, not enjoying life.
Day Seven (October 8th)
It’s starting to look nasty and is incredibly painful to put pressure on. Antibiotics don’t take effect immediately and signs of improvement usually begin 24 to 48 hours after taking the first dose – so at this point I still had faith that this was the dark before the dawn. The only issue was that I had to fly four hours from Manila to Bali and human tissues can expand up to 30% in the pressurized cabins during flight.
It was excruciatingly painful and I tried my best to play as much Catan as possible on my phone to ignore the feeling that my foot was about to explode during the flight with each heartbeat. Thankfully I had the row to myself and I just kept my foot elevated in the air to the horror of other passengers. Rating: 2/10 someone help me.
Day Eight (October 9th)
I’m now in Bali at a beautiful villa that I had splurged on because I figured if I was going to be bed ridden for a week or so then I’d want a nice view. I shared the picture on the left with a good friend and he told me to not be so flippant about the wound, that enough time had passed since the doctors in the Philippines, and go get it checked out again immediately before necrosis potentially sets in. So off I went, hobbling and hopping on one food to a taxi to take me to the nearest clinic in Ubud Bali.
The clinic was sparse but efficient and the second I took off my bandage the doctor said ‘cellulitis’. She didn’t even need to double check and she told me whatever medication the doctor prescribed me in the Philippines was clearly not working. So she did a proper wound clean with some scraping (not fun), told me how to care for it, prescribed me two types of antibiotics that should wipe out anything I had, and let me rent some crutches. She told me to prepare for the antibiotics not to work at all at this point and if that does happen, that I’ll need to go to a proper hospital and get an antibiotic drip to see if that could clear out the infection. She was so pretty and said it all with a calm, knowledgeable, and kind demeanor that I decided I wanted to be like her when I grew up.
I asked her if cellulitis was common in Indonesia (me thinking smugly that this must be a developing country disease) and she happily told me that yes it was common but that she saw it mostly in foreigners coming for the Bali experience, since their immune systems are not able to cope with the foreign bacteria in other countries. She said while my case was pretty bad that she had seen even worse which did give me some immediate relief that I wouldn’t have to go Amazon shopping for some peg legs. Getting a peg leg would be a cool silver lining, although I am quite fond of my foot. She did send me home with crutches which had me hobbling around like Speedy Gonzalez, freed at last from my inability to move on my own. Rating: 2/10 because the pain is severe enough where I was struggling to sleep at night.
Day Nine (October 10th)
Sorry for this unholy filth of an image, my foot was NOT in a good shape and I couldn’t clean it up since moving it or touching it was agony. I did however warm it up in the water and scrape away some more puss with a needle and knife right before this photo.
One day post antibiotics and it is starting to look less like a perfectly cooked hotdog bursting at the seems. It would still make a small child cry but the improvement gave me hope and I stopped wallowing in my doom and gloom. Also, the medicine that the pretty lady doctor gave me included something that I thought was Ibuprofen, turns out it was codeine. Damn that stuff rocks. Rating: 8/10, for the
Day Ten (October 11th)
The swelling has gone down and I can almost walk normally again without crutches! I was over the moon that day even if my left foot looked like it could be an extra on the Walking Dead. 8/10
Day Twelve (October 13th)
By now I am off the crutches at last. There’s still discoloration and it’s still infected with occasional shooting pains but I could now sleep without it being propped up on pillows. Also, I stopped taking any more Codeine since it’s addictive and all, also when I had one, I thought I was invincible and walked all over on my foot without crutches earlier in the day thinking how glorious the world of medicine was. When the pain pills wore off I was in a world of pain and realized that, in this case, pain was trying to tell me something: rest and stay off your goddamn foot. Rating: 8/10
Day thirteen (October 14th)
Discoloration is continuing to go back to normal, this was the day I started trekking and planning the rest of my Bali trip now I knew I could walk again, I was starting to fill with excitement at my upcoming prospects of adventure.
I went for a walk down a town street, tripped, fell on gravel, and skinned my knee bad as a kind Balinese woman rushed to get my napkins. It was on the same leg as this injury – at least I made some people laugh. Rating: 9/10
Day fourteen (October 15th)
I am now at 90% mobility. Two weeks after the initial injury, three different kinds of antibiotics, two different doctors in two different countries, I’m finally given the official approval that I will be okay and can frolic as before. However, I was warned to stay on the lookout and keeping it nice and clean and dry until all discoloration is gone. Rating: 10/10
What I did with my first taste of freedom – hang around animals with an open wound on my knee. When will I ever learn??
Day Nineteen (October 20th)
It’s still on the road to improvement and looking normal. Rating: 10/10
Day Twenty-Four (October 25th)
Still slight discoloration but now I am
not less ashamed to show my feet in public. Rating: 10/10
Day Thirty (October 31st)
This photo is about a month after the initial injury and you can see how it has healed just in time for me to fly out to Nepal! The injured foot still ached but not at all debilitatingly and I just made sure to rest it a bit more. I was told that coral cuts can take longer than normal to heal and so that’s to be expected.
I’m writing this paragraph one year later and the scars on my left foot look almost the same as the photo above – the cuts never quite healed and they are now large keloid scars that itch whenever the weather changes so I guess that now makes me a witch instead of the potential pirate I could’ve become. I’m thankful for the lessons I have learned and the scars are a reminder of proper wound care, especially when traveling to rural destinations!
Me hiking and almost injuring myself at Mt Batur just a few weeks later: